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Andrew's Progress Log
I really liked that you have also looked into the possible excretion rates and possible total body storage of vitamin A.
I especially like your model with 0.5 % excretion of present stores per day but with a capped maximum excretion amount. That seems most realistic to me. I otherwise thought of the losing-a-percentage-each-day models as just unreasonable, since with them it wouldn't even matter what one's inital liver stores was.
I looked into estimating detox of vitamin A hoping to making a sheet to make a guestimation when starting out. Though now I think like puddleduck that it is quite difficult to make a somewhat accurate estimation. So I think I lost a little bit of interest in making an estimation when I realised that a vitamin A depletion time model will have a great deal of stacked estimation errors, like:
- Liver weight estimation
- Liver/body percentage storage estimation
- Liver concentration estimation
- Excretion rate model estimation
- Vitamin A intake estimations (most real food have some carotenoids or retinoids)
On top of that most real food have have some vitamin A and that is also important since net excretion is simply written as:
(Net Excretion) = (Excretion) - (Intake)
For example here is a table showing that meat contains vitamin A. The table is from a 1988 study measuring some retinoids and carotenoids in store bought meats (study available at sci-hub):
https://doi.org/10.1016/0889-1575(88)90022-1
On the topic of extreme excretion rates I haven't seen any radioactively labelled retinoid studies on it which I think seem like the best type of studies to estimate total excretion.
Another possible explaination for what seems like an extreme excretion rate is that they first did a biopsy on a more cirrotic part of the liver (more dry and higher concentration) then when they retested again on that 62 year old man the tested a spot that was less cirrotic and/or less filled with vitamin A. -Though I believe that the pressure differential of superficial toxins to move out of the liver is greatest at the start like the percentage based models suggest.
Also I don't believe that vitamin A is perfectly evenly distributed in the liver. The liver is not a homogenous blob after all, it has two lobes after all.
PS. There are also more fat-soluble things, other than vitamin A, in the liver. Comparing the Leathal Dose 50 % (LD50) for different toxins in relation to normal exposure might point towards which fat-soluble toxin might be the worst. Though that would not account for synergistic effect between toxins and it would only look at acute toxicity effects from a relatively quick overdose.
If you are interested, this is what I wrote in 2021 on the subject of estimating liver accumulation of vitamin A with a screenshot from a spreadsheet I made of it:
"Hi!
I looked a bit about the amount of vitamin A in the liver, since the liver is seen to store most of the vitamin A in the body. The liver amount is the focus of these calculation since the liver has been studied quite a bit in term of vitamin A storage with liver biopsies of dead people (of all causes). Any whole body estimation will mostly be a guess which probably differs a lot from person to person. There is even more vitamin A (in different forms) also stored outside the liver. I haven't looked for any study measuring vitamin A (in all forms) and how it is stored in the rest of the body.
The calculation unit used is Retinol Equivalent (RE) because older studies are used. Retinol Equivalent (RE) is almost the same as Retinol Activity Equivalents (RAE) but it scales down the effect of carotenoids by twice as much as RE. Since the liver mostly contains retinyl esters both RE and RAE gives the same results in terms of amount of vitamin A storage in the liver.
An average male liver is here assumed to weigh 1450 g and an average female liver to weigh 1300 g. https://www.ncbi.nlm.nih.gov/books/NBK421/
The liver concentrations of vitamin A is taken from this 2018 report:
"Serum retinyl esters are positively correlated with analyzed total liver vitamin A reserves collected from US adults at time of death"
https://doi.org/10.1093/ajcn/nqy190
It has four interval listed in (µmol of vitamin A as retinol equivalent=RE) per gram of liver tissue:
Deficiency: <0.1 μmol RE/g of liver
Optimal: 0.1-0.7 µmol RE/g of liver
High: 0.7-1.0 µmol RE/g of liver
Toxicity: >1.0 µmol RE/g of liver
I use the retinol's molar mass of 286.45 g/mol to convert the given retinol equivalent values given in the 2018 study above to µg/g instead of µmol/g. https://en.m.wikipedia.org/wiki/Retinol
To put the calculated vitamin A liver amounts (retinol equivalents) in perspective I used "Estimated Average Requirement" (EAR) for vitamin A from the USDA report called "Dietary Reference Intakes (DRIs): Estimated Average Requirements for Groups" from ~2005 (in RAE), https://www.nal.usda.gov/sites/default/files/fnic_uploads/recommended_intakes_individuals.pdf (broken link) and the USA RDA for vitamin A (in RAE) from 2020, https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/. I then divided the amount of liver stored vitamin A (RE/RAE) for different daily amount of vitamin A given by the EAR (~2005) and by the RDA (2020). This gave an estimation of how many days of vitamin A (retinol activity equivalent) that is stored in the liver for different stages of vitamin A toxicity if the EAR or the RDA was an individual vitamin A excretion rate per day.
Since there are difference between adult females and adult males I calculated values for both of these. The amount of RDA stored in a toxic hypervitaminosis A liver (286.5 µg/g of liver) or even worse (572.9 µg/g of liver) confirms what Dr. Smith says about "It is a marathon and not a sprint".
In comparing the liver concentration of borderline hypervitaminosis A (286.5 µg/g of liver) to what might be the highest recorded liver concentration of vitamin A, 3131 µg/g (10438 IU/g of liver) from a 1962 New Zealand study. Thank you Dr. Smith for finding this 1962 study!
"Vitamin A content of human liver from autopsies in New Zealand" from 1962 by Barbara M. Smith and Eileen M. Malthus of the Nutrition Research Department, Medical Research Council of New Zealand, University of Otago Medical School, Dunedin, New Zealand. https://www.cambridge.org/core/services/aop-cambridge-core/content/view/05E995B9E0FDDD52191FAB96494ABBDA/S0007114562000227a.pdf/vitamin-a-content-of-human-liver-from-autopsies-in-new-zealand.pdf
The record liver concentration came from 21 year old male who had been daily poisoned with 15000 µg (50 000 IU) of vitamin A supplementation at the hospital (where he was because of an unsuccessful suicide attempt, by drinking caustic soda). The study doesn't say how long the 21 year old was on this additional high dose vitamin A supplementation before it killed him. The same study notes that in rat experiments (earlier than 1962) they had seen livers with a concentration of 3000 µg/g of liver (10000 IU/g of liver). That seems to be the highest concentration of vitamin A that a rat liver and possibly a human liver can store right before dying.
I included this record liver concentration of vitamin A in the table as I see it as some sort of a maximum value, a roof of how high the liver concentrations can reach. Most of us here probably has a liver concentration of vitamin A somewhere between the extreme case and the hypervitaminosis A liver concentration."
End comment: I thought that 20 years to get rid of vitamin A looked unreasonable at the time but for some delicate and heavily damaged tissues that might be the time frame without any special intervension other than stopping a high dose vitamin A supplement. See this previous thread with a study on how eyes was seriously damaged by an extreme form of carotenoid supplementation and still leaves vague marks 20 years after stopping the supplement. See for yourself the picture from the study in this thread:
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@puddleduck - very interesting. I may or may not have turned a few white t shirt under-arms an off-colour after 6-12 months... gross hahaha.
@David these were awesome, thanks! I agree - the "c. 0.5% with a cap" is probably the most realistic.
But yes, thanks for all that information! There are so many things to take into account that I missed ... it's never simple is it? Hahaha
Awesome spreadsheet and calculations - I love the way you think! Shame about the timeframes though.
I am glad you enjoyed my comments!
Like I said about a cirrotic liver shrinking I think this is also the case in my spread sheet screen shot I attached in the earlier comment. With the extreme case, I think there would be a shrinking liver volume which would lower the total vitamin A amounts in the liver.
Regarding the time frame I think healing just one specific part of the liver will probably give some positive effects, the liver has two lobules but the portal vein also spreads out in branches. Once one begins to have some noticeable initial progress I think one should try nurse that improvement in order to avoid possible relapse.
A linear extrapolation model, like the 0.5 % excretion model (linear exponent model), can after all only be so fitting for all possible circumstances. The wider the spectrum the harder to make precise general model. Though like Grant Genereux wrote in a recent comment about vitamin A content in food, a rough approximation of vitamin A is probably good enough for most things as in his comment below (https://ggenereux.blog/discussion/topic/eggs-as-part-of-vitamin-a-reduction/?part=57):
Quote from ggenereux on July 21, 2023, 6:59 amRE: We do not know with great precision how much Vitamin A you (or I, or anyone else) is consuming.
We don’t need to know that with great precision. This is not nuclear physics. Close approximations are good enough here. The current claim is that vitamin A is “vital”, essential for vision and for life, and the RDA is 3000-4000 IU.
Well, if it’s so vital, then by now I and others should have experienced at least some detrimental effects after being at near zero amounts of it. In my case for 9 years, and others meat only carnivores for 10-20 years with zero signs of vA deficiency.
Sure, there’s small amounts of vitamin A in muscle meats. In my diet I think it’s about 3-4 IU /day. But, that’s 1,000 times lower than the RDA of the “essential” vitamin. In my books, when the “science” is off by a 1,000 fold, that is as good as a complete miss. In other words, they’ve obviously got it completely wrong.
Additionally, I make regular plasma donations (now on donation # 37) and that almost surely offsets the 3-4 IU I get from eating meat.
Of course, I also have been taking in some small amounts of lead arsenic due to my rice consumption. Since I haven’t died, should we then accept someone’s claim that it is somehow needed and essential too?
RE: We do not know how much Vitamin A is stored in your liver
Actually, it wouldn’t be surprising at all if there’s still some of this vile yellow toxin “stored” in my liver. As there is no doubt other POPs such as dioxin, PCPs, benzenes etc. Is that evidence that they are somehow vitamins too? No, of course not, they are all toxins."
Also I don't want to discourage you or anyone else from trying to create a simple model of detox time of vitamin A but like you said it might not be that easy. Such a model would probably have a big margin of error due to the stacking (multiplication) of several error margins from the approximations that are done; sometimes less parameters might be more. Your capped 0.5 % depletion model might just be good enough to get some meaningful approximations. I think the difficult part would be to estimate one's general liver concentration of vitamin A.
-How would you really know how toxic your liver are without serious testing, like a liver biopsy or a serum retinol ester test?
Here are some estimation formulas that already exists for estimating liver volume from things like body weight and body thickness:
2008 paper: [Establishment of formula predicting adult standard liver volume for liver transplantation]"
"TLV [Total Liver Volume] (ml) [ml = cm3]= 12.5 x BW (kg) + 536.4 (r(2) = 0.43, P < 0.01)"
https://pubmed.ncbi.nlm.nih.gov/19094671/
2017 paper: "A new formula for estimation of standard liver volume using computed tomography-measured body thickness"
"A formula for TLV (cm3 ) was derived: 2 × [body] thickness (mm) + 10 × weight (kg) + 190 with R2 0.48, which was the highest when compared with the 4 other most often cited formulas."
https://pubmed.ncbi.nlm.nih.gov/28650089/
Here is a DOI-link to the 1975 Sauberlich, H. E. et al. study with two attached tables. The study is available at sci-hub and it is called:
"Vitamin A Metabolism and Requirements in the Human Studied with the Use of Labeled Retinol"
https://doi.org/10.1016/s0083-6729(08)60015-1
It is a study done with 8 men in the ages of 31-43. They ate a "vitamin A free" diet as loosely specified in one of the attached tables. That casein was surely heat treated and most likely contained some retinoids.
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@David - thanks for all of this information. Really thought-provoking, and I appreciate you taking the time.
Now that I've fully digested it, the info is quite damning... still, I prefer a harsh truth than a comforting lie though, any day.
I guess I've just gotta stick to the plan, continue life as a husk for the foreseeable, but hope for the best.
I haven't had a blood test taken yet but will do soon. I thought the interesting things would be: hormone panels, thyroglobulin and TPO antibodies (these were through the roof in Jan 2023, I doubt they'll have comes down after just 24 days of low-to-no vA, but it'll give me an approx. starting point), serum retinol (I know this doesn't tell us much, but just to get a starting value), iron panel etc.
Off-hand, does anyone know why platelet count would be low? Mine is on the low end of the "normal range". I had heard a hypothesis that the platelet count is probably not that low, but they are sticking to the sides of the blood vessels due to the slow moving, inflamed supply (due to low thyroid function etc.).
I also haven't taken any appropriate pictures yet - I did take a few, but my ankles look absolutely disgusting (spider veins) - they look way worse in the photo than they do in real life! I'll try and take some in better lighting soon.
BLOOD TEST RESULTS - Immunity Markers
January 2023 - prior to low vA diet, and prior to thyroid supplementation: Thyroglobulin Antibodies 383 IU/mL (scale = 0-115, so very elevated). Thyroid Peroxidase Antibodies 400IU/mL (scale = 0-34, so extremely elevated).
I commenced Thyroid Hormone Supplementation in March 2023
Commenced low vA diet (beef, chicken, rice, beans, apples, bananas, cola) July 1st 2023
August 2023 - Thyroglobulin Antibodies 677 IU/mL (absolutely through the roof), Thyroid Peroxidase Antibodies >600 (literally above the measurement capabilities).
Not sure what could have happened in Feb-Jun in terms of Thyroid Antibodies, but I can certainly say that the month or so of low vA, and the previous few months on thyroid hormone supplementation, have done nothing to bring these numbers down. They have actually increased by c. 50%.
Not sure why. Very early days for now though - going to stay the course for sure. Anyone seen their numbers come down?
Vitamin A Serum results are incoming.
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@andrew2 hi it looks like you have issues with minerals(copper) and maybe metals like mercury. If you can do hair test in TEI and blood test for copper+ceruloplasmin, estrogen, prolactin, TSH, free T3, free T4 and cholesterol.. You have varicose veins/spider veins due to low bioavailable copper and high estrogen. Gynecomastia is from elevated estrogen/prolactin as well.. I would start taking small doses of vit C(200-500mg) in the morning empty stomach 20 min before food. zinc 15-20mg with dinner and molybdenum around 100mcg daily or around 400mcg once a week.. Also selenium(L methionine) 200mcg with breakfast. Do you have amalgams? What other issues do you have like mental, digestive, skin issues, how looks your poop. Dark sinking or pale floating?
@jiri - thanks. Yes, I am aware of most of these things. Although not sure I understand the copper point.
Already taking zinc, molyb, selen.
My symptom list is in a table on the first page of this thread. I won't repeat here, otherwise this reply would be extremely long hahaha.
No amalgams. No fillings. Poop sinks, darker coloured.
I have much more comprehensive bloods. But wasn't going to post them here. What I really wanted to show was if this diet could bring autoimmunity blood markers down from very high, to in the normal range, as the years go by... definitive proof (or not) of "auto-"immune reduction.
I am currently investigating iron overload... very high total testosterone (950ng/dl), average free test, slightly higher oestradiol, higher prolactin but not extremely, high SHBG, elevated transferrin saturation (42), high ferritin (300) - quite worried that it is hereditary hemochromatosis, but I don't know how to distinguish between just an iron accumulation (I eat a lot of red meat, and was on the carnivore diet for two years) and hereditary hemochromatosis.
@andrew2 " but I don't know how to distinguish between just an iron accumulation (I eat a lot of red meat, and was on the carnivore diet for two years) and hereditary hemochromatosis."
It doesn't matter. Just keep ferritin in healthy range like under 100...